This study seeks to describe the factors that influence the decision making of African American and Caucasian women with early stage breast cancer to adhere to recommended chemotherapy treatment. The diagnosis of breast cancer is a very stressful event, requiring the woman to make multiple decisions about her care. However, their decisions may or may not be consistent with the recommendations of the healthcare provider. Because of ethnic differences observed in the treatment and survival between Caucasian and African American women with breast cancer (2-4), the extent to which adherence rates and the variables that effect treatment decision making in both groups must be better understood. The specific aims of this study are: 1. to examine differences in adherence to chemotherapy between African-American and Caucasian women with early stage breast cancer in relation to socio-demographic factors, social interaction factors, cancer experience, breast cancer knowledge, and health beliefs;and 2. to explore relationships among socio-demographic factors, social interaction factors, cancer experience, breast cancer knowledge, and health beliefs as predictors of adherence to chemotherapy in African American and Caucasian women with early stage breast cancer. This prospective predictive study will use a sample of 120 women to identify significant predictors and ethnic differences of chemotherapy treatment decision making. A Demographics Measure, Trust in Physician Scale, Norbeck Social Support Questionnaire, the Pargment Religious Coping Scale, the Comprehensive Breast Cancer Related Knowledge Scale, Memorial Symptom Assessment Scale Short Form, the Powe Fatalism Inventory, Center for Epidemiologic Studies-Depression and the Champion Health Belief Model Scale will be used for data collection. The National Institute of Nursing Research is interested in research that identify the factors that influence decision making that results in behavioral changes that promote health and to define the behaviors that support adherence to treatment for complex diseases(5). This study is well aligned with NINR's mission as it seeks to accomplish my long term goal to build on the necessary research needed for patients in their decision making process in order to promote positive health outcomes and reduce health disparities seen in African American women with breast cancer. The relevance to public health of the research is to reduce health disparities seen in survival outcomes among African American women with breast cancer. An overarching goal of Healthy People 2010 is to eliminate health disparities, specifically racial differences seen in cancer survival. PUBLIC HEALTH RELEVANCE: Training goals: To acquire the knowledge and skills related to the study of decision making in women with breast cancer in order to conduct scientifically sound research. My research will focus on the factors that influence African American women with breast cancer to terminate their recommended treatment early;given this population study has a high mortality rate from breast cancer. This goal will be accomplished by developing relevant research question on the science of treatment adherence and the decision making process of women with breast cancer, based on a theoretical framework and the current body of literature, designing and implementing a research project, analyzing the results with appropriate statistical procedures ,and disseminating the findings in the scientific literature.